Provider Demographics
NPI:1356953319
Name:MED-CARE SUPPLIES, LLC
Entity type:Organization
Organization Name:MED-CARE SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ELIAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:DEMOZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-321-6396
Mailing Address - Street 1:4700 WALDEN LN STE B
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4848
Mailing Address - Country:US
Mailing Address - Phone:410-970-2949
Mailing Address - Fax:
Practice Address - Street 1:4700 WALDEN LN STE B
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4848
Practice Address - Country:US
Practice Address - Phone:410-970-2949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-20
Last Update Date:2023-09-19
Deactivation Date:2023-06-21
Deactivation Code:
Reactivation Date:2023-07-11
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies